Active NPI
Jennifer Grossman Reid, M.D.
- Psychiatry Physician
- Philadelphia, PA
National Provider Identifier
1073767208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD452253
- Practice address
- 3535 Market St
3Rd Floor
Philadelphia, PA 19104-3309 - Phone
- (215) 746-6700
- NPI assigned
- Nov 14, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD452253 | PA | Primary |
Addresses
Primary practice location
3535 Market St
3Rd Floor
Philadelphia, PA 19104-3309
Mailing address
3535 Market St
3Rd Floor
Philadelphia, PA 19104-3309
Phone (215) 746-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0A1083860 | Medicaid | CA |
Other names 1
- Jennifer Lyn Grossman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 12, 2019 through Aug 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1073767208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3535 MARKET ST",
"address_2": "3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043309",
"telephone_number": "215-746-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3535 MARKET ST",
"address_2": "3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191043309",
"telephone_number": "215-746-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "JENNIFER",
"middle_name": "GROSSMAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-14",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD452253",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0A1083860",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "GROSSMAN",
"middle_name": "LYN",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.